scholarly journals Clinical utility of TIRADS and ultrasound elastography in characterization of thyroid nodules

2019 ◽  
Vol 7 (2) ◽  
pp. 328 ◽  
Author(s):  
Namrita Sachdev ◽  
Sana . ◽  
Shivani Gupta ◽  
Akhila Prasad
Keyword(s):  
Clinical Utility ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Ultrasound Elastography ◽  
Strain Elastography ◽  
Elasticity Score ◽  
Arfi Imaging ◽  
Benign Thyroid

Background: Thyroid nodules are a common entity in an iodine deficient population, however malignant nodules are relatively uncommon with excellent prognosis. Ultrasound elastography is a useful tool for characterization of nodules and allows selection of tumors for FNAC. This study aimed to evaluate the diagnostic value of strain elastography and acoustic radiation force impulse (ARFI) imaging in differentiating malignant from benign thyroid nodules.Methods: This study included 100 thyroid nodules evaluated using ultrasound TIRADS classification. Strain elastography evaluated the nodules using the elasticity score and strain ratio followed by VTI and shear wave velocity generated from ARFI data to characterize the nodules. Final diagnoses were obtained from cytological and/or histological evaluation. The diagnostic performance of the two elastography methods was analyzed and compared by multiple receiver operating characteristic curve analysis.Results: Of the 100 thyroid nodules observed in 100 patients (82 females and 18 males), 22% were malignant nodules and 78% were benign. The cut off values for elasticity scores, mean SR, VTI grade and mean SWV for predicting malignant thyroid nodules were greater than or equal to score 2, 2.4, grade 3, 2.5m/s respectively. The area under the receiver operating characteristic curve for elasticity score, mean SR, VTI grade and mean SWV was 0.79, 0.78, 0.89 and 0.84, respectively (P>0.05) and the accuracy was 74, 81.6, 88 and 87.5%, respectively (P>0.05). The accuracy of the combined use of conventional sonography, strain elastography and ARFI imaging was 85.6% respectively, which was higher than that of conventional sonography (P>0.05).Conclusions: Strain elastography and ARFI imaging have high sensitivity and specificity for differentiating malignant from benign thyroid nodules and therefore have good clinical utility in evaluating these lesions.

The contribution of strain patterns in characterization of prostate peripheral zone lesions at transrectal ultrasonography

2012 ◽  
Vol 53 (1) ◽  
pp. 119-126 ◽  
Author(s):  
Yan Zhang ◽  
Jie Tang ◽  
Yan-mi Li ◽  
Xiang Fei ◽  
En-hui He ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Peripheral Zone ◽  
Diagnostic Value ◽  
Ultrasound Elastography ◽  
Transrectal Ultrasonography ◽  
Targeted Biopsy

Background Elasticity is an important characteristic of tissue. During an elastography examination, various strain images of lesions are observed, and a suitable classification of strain patterns (SP) may provide vital diagnostic information about lesions. Numerous studies have shown that ultrasound elastography can improve the detection of prostate cancer, but the diagnostic value of SP classification has not yet been fully evaluated. Purpose To investigate the contribution of SP on the characterization of prostate peripheral zone lesions by transrectal real-time tissue elastography (TRTE) in combination with conventional transrectal ultrasonography (TRUS). Material and Methods One hundred and seventy-one patients with suspected prostate cancer underwent TRUS and TRTE examinations. The SPs of the suspicious lesions were classified into five scores by TRTE according to the degree and distribution of strain. All findings were confirmed by transrectal systematic 12-core biopsies and targeted biopsies for suspicious areas detecting by TRUS and/or TRTE. Results One hundred and forty-eight of 171 patients had high-quality TRTE imaging and were included into the study. When a cut-off point of SP score III was used, the area under the receiver-operating characteristic curve (AUC) was, respectively, 0.75 (95% CI: 0.67–0.83), 0.85 (95% CI: 0.78–0.91) and 0.84 (95% CI: 0.77–0.91) for the diagnosis of prostate cancer by TRUS, TRTE and TRTE + TRUS. A linear tendency of SP and Gleason scores was observed in scores III-V. The detection rate of prostate cancer using TRTE-targeted biopsy (75.8%) was significantly higher than that of systematic 12-core biopsy plus TRUS-targeted biopsy (14.5%) ( P = 0.00). Conclusion This study suggests the significant contribution of SP on characterization of prostate peripheral zone lesions and the improvement of TRTE-targeted biopsy on detection of prostate cancer.

Suggested amendment of TI-RADS classification of thyroid nodules by shear wave elastography

2019 ◽  
Vol 61 (8) ◽  
pp. 1026-1033
Author(s):  
Jin-Ru Yang ◽  
Yan Song ◽  
Shan-Shan Xue ◽  
Li-Tao Ruan
Keyword(s):  
Shear Wave ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Shear Wave Elastography ◽  
Needle Aspiration ◽  
Ultrasound Elastography ◽  
Conventional Ultrasound ◽  
Ultrasonic Shear

Background The application of the ultrasound elastography and Thyroid Imaging Reporting and Data System (TI-RADS) classification further expands the scope of ultrasound differential diagnosis between benign and malignant thyroid nodules. Purpose To investigate the value of the quantitative parameter of ultrasonic shear waves in optimizing the TI-RADS classification of thyroid nodules. Material and Methods A total of 168 thyroid nodules, initially classified using TI-RADS and scanned by shear wave elastography (SWE), were retrospectively analyzed. All cases were diagnosed by fine needle aspiration and histology following surgery. Results The benign rate of TI-RADS 3 nodules was 76.5%, while the benign rate of TI-RADS 4a nodules was 71.7%. Furthermore, the malignant rate of TI-RADS 4b nodules was 69.7%, while the malignant rate of TI-RADS 4c nodules was 85.7%. In differentiating benign from malignant nodules, the combination of TI-RADS classification and Emean had the largest area under the receiver operating characteristic curve (AUC). Using an Emean value of 42.25 kpa as the cut-off point, the malignant rate of TI-RADS 4a nodules decreased from 28.3% to 23.5%, while the malignant rate of TI-RADS 4b nodules increased from 69.7% to 79.4%. Compared to conventional ultrasound alone, the sensitivity, negative predictive value, and AUC of conventional ultrasound combined with SWE in the diagnosis of benign and malignant thyroid nodules significantly improved ( P=0.012, 0.029, 0.001). Conclusion The SWE technique can be used to further determine the benign and malignant nature of TI-RADS 4 lesions, providing further reference for the choice of clinical treatment. The TI-RADS classification system corrected by SWE is more significant in the diagnosis of benign and malignant thyroid nodules.

LncRNAs SNHG12 and LINC00152 were associated with progression of patients with papillary thyroid carcinoma

2019 ◽  
Vol 15 (36) ◽  
pp. 4167-4179 ◽  
Author(s):  
Jianqiu Liu ◽  
Xinyue Tang ◽  
Jing Lv ◽  
Xiaowei Peng ◽  
Ke Zhang ◽  
...  
Keyword(s):  
Gene Expression ◽  
Papillary Thyroid Carcinoma ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Diagnostic Value ◽  
Gene Expression Omnibus ◽  
Papillary Thyroid ◽  
Normal Tissues ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Aim: To investigate the clinical roles of LINC00152 and SNHG12 in papillary thyroid carcinoma (PTC). Methods: LINC00152 and SNHG12 expression was sought and analysis in gene expression omnibus, The Cancer Genome Atlas and GEPIA datasets. Tumor and adjacent normal tissues were collected from 97 PTC and 44 benign thyroid nodules patients. The expression was evaluated by quantitative real-time polymerase chain reaction. The association between the expression level and clinicopathologic characteristics was analyzed by χ2 test. Receiver operating characteristic curves were plotted to evaluate the diagnostic value. Results: The expression of SNHG12 and LINC00152 were significantly higher in PTC tissues than in adjacent normal tissues not only in gene expression omnibus database but the validated samples. More interesting, LINC00152 expression level was also significantly higher in PTC tissues than that in benign thyroid nodules. The upregulation of LINC00152 and SNHG12 was associated with the malignant progression of PTC. Receiver operating characteristic curve analysis also demonstrated that there was a good trend, which indicates that they may have certain diagnostic value. Conclusion: LINC00152 and SNHG12 might serve as serve as potential related molecules of PTC.

A Closer Look at “Taller-Than-Wide” Thyroid Nodules: Examining Dimension Ratio to Predict Malignancy

2021 ◽  
pp. 019459982110513
Author(s):  
Aviva S. Mattingly ◽  
Julia E. Noel ◽  
Lisa A. Orloff
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Continuous Variable ◽  
Width Ratio ◽  
Likelihood Ratios ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Objective To evaluate nodule height-to-width ratio as a continuous variable predicting likelihood of thyroid malignancy. Study Design Retrospective cohort study. Setting All study information was collected from a single academic tertiary care hospital. Methods Subjects included adult patients with thyroid nodules who underwent thyroid surgery between 2010 and 2020. The following variables were collected: patient demographics, nodule dimensions via ultrasound, fine-needle aspiration biopsy results, and surgical pathology results. Statistical analysis included logistic regression modeling malignancy with variables of interest. We used a receiver operating characteristic curve to assess the discriminatory value of variables. Results Height-to-width ratio, as a continuous variable, was associated with malignancy (with each 0.1 increase in ratio; odds ratio [OR], 1.25; 95% CI, 1.14-1.37). The same relationship was true for height-to-length ratio (OR, 1.36; 95% CI, 1.24-1.56). The area under the receiver operating characteristic curve for height-to-width ratio was 63.7%. In line with current emphasis on the transverse ultrasound view, we determined 4 different height-to-width ratio intervals: <0.8, 0.8 to <1.0, 1.0 to <1.5, and ≥1.5. Likelihood ratios of malignancy for each interval were 0.6, 1.0, 2.3, and 4.9, respectively. Conclusion Our results support the association between greater height-to-width ratio and malignancy but suggest that a multilevel rather than binary variable improves prediction. The likelihood ratios at different intervals give a more nuanced view of how height-to-width ratio predicts malignancy. With continuing review of guidelines for thyroid nodule biopsy, it is important to consider these data for any point total attributed to shape.

SERUM THYROGLOBULIN AND ANTI THYROGLOBULIN LEVELS IN PATIENTS WITH THYROID NODULES

2020 ◽  
pp. 73-78
Author(s):  
Hung Nguyen Trung ◽  
Thuy Nguyen Hai ◽  
Quan Nguyen Phuoc Bao
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Serum Thyroglobulin ◽  
Elasticity Score ◽  
Thyroglobulin Level ◽  
The Mean ◽  
Operation Results ◽  
The Relationship ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Objectives: To compare the levels and pathological values of serum Tg and TgAb between the patients with benign and malignant thyroid nodules and evaluate the relationship between serum Tg and TgAb levels with the rim characteristic and elasticity score of the nodule by thyroid elasto-echography. Subjects: 30 patients with thyroid nodules, Serum Tg and TgAb levels and thyroid elasto-echography are examen before operation. Results: The ratio of the positive Tg level of malignant thyroid nodules was higher than the benign thyroid nodules (16.7% vs 8.3%) but the serum Tg level was not significantly different (33.48 ± 38.67 ng/ml vs 27.32 ± 28.44 ng/ml, p > 0.05) and The ratio of positive TgAb level of malignant thyroid nodules was higher than that of benign thyroid nodules (22.2% vs 0%) but serum TgAb level was not different (64.15 ± 14.91 UI/ml vs 16.9 ± 14.48 UI/ml, p > 0.05). The combination of the ratio of positive Tg and positive TgAb level did not show any difference in the ratio of pathological value between benign and malignant thyroid nodules (5.6% vs 0%). Serum Tg levels in patients with irregular rim thyroid nodules were higher than those in patients with regular rim thyroid nodules but the serum Tg level was not different when evaluated with the elastic score. Conclusions: The mean level and ratio of the pathological value of serum Tg and TgAb did not differ between malignant and benign thyroid nodules. There is a relationship between serum Tg level and irregular rim characteristic of thyroid nodule (p < 0.05). Key words: serum thyroglobulin level, serum anti thyroglobulin level, thyroid nodule.

Diagnostic Value of Acoustic Radiation Force Impulse Quantification in the Differentiation of Benign and Malignant Thyroid Nodules

2017 ◽  
Vol 39 (5) ◽  
pp. 326-336 ◽  
Author(s):  
Niraj Nirmal Pandey ◽  
Gaurav Shanker Pradhan ◽  
Alpana Manchanda ◽  
Anju Garg
Keyword(s):  
Thyroid Nodules ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Shear Wave Speed ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

The objective of this study was to evaluate the role of ultrasound elastography using acoustic radiation force impulse (ARFI) quantification in characterizing and differentiating malignant versus benign thyroid nodules. A total of 40 thyroid nodules were evaluated with conventional sonography and ultrasound elastography using ARFI quantification. The final diagnosis was obtained from histologic findings. A total of 14 malignant and 26 benign nodules were diagnosed on the basis of histologic examination. Majority of the malignant thyroid nodules demonstrated presence of intranodular vascular flow, hypoechoic echotexture, absent halo, irregular margins and microcalcifications. However, a considerable overlap was noted in the sonographic features of malignant and benign thyroid nodules. On ARFI quantification, the mean shear wave speed (SWS) values ( M ± SD) of malignant and benign thyroid nodules were 3.131 ± 0.921 m/s and 1.691 ± 0.513 m/s, respectively. A significant difference was observed between the mean SWS values of malignant thyroid nodules and benign thyroid nodules ( p < 0.0001). Applying a cutoff value of 2.53 m/s, the sensitivity, specificity, and the area under the receiver operating characteristic curve for the differentiation were 85.71%, 96.15%, and 0.922, respectively. ARFI quantification is a promising elastography technique that provides quantitative information about tissue stiffness. It provides additional information and complements sonography as an effective diagnostic tool in characterizing and differentiating benign from malignant thyroid nodules.

scholarly journals Diagnostic accuracy of B-mode ultrasound, ultrasound elastography and diffusion weighted MRI in differentiation of thyroid nodules (prospective study)

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mahmoud Abdel Latif ◽  
Magdy Mohamed El Rakhawy ◽  
Mohamed Fathy Saleh
Keyword(s):  
Thyroid Nodules ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Thyroid Ultrasound ◽  
Diffusion Weighted Mri ◽  
Adc Value ◽  
Diffusion Weighted ◽  
And Diffusion ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background The incidence of the thyroid nodules and its detection is increasing rapidly. The most precise method for diagnosis of the nodules of the thyroid is FNAC. But, about 10–20% of specimens of FNAC are indeterminate and non-diagnostic. Therefore, there is a demand for another diagnostic method for evaluating thyroid nodules. Thyroid ultrasound elastography may improve the ability to differentiate malignant from benign thyroid nodules. Few articles were published about the results of DW MRI in thyroid nodules, with its results confirmed that malignant nodules have lower mean ADC values than benign nodules. This study aims to investigate and compare the accuracy of B-mode ultrasound, ultrasound elastography and diffusion-weighted MRI in characterization of the nodules of the thyroid. Results The study included 56 patients with thyroid nodules (36 benign and 20 malignant). Thyroid ultrasound, ultrasound elastography and DWI were done for all patients. Ultrasound-guided FNA Cytological examination (as the gold standard) was done for 48 patients and surgical histopathology was done to 8 patients with non-diagnostic FNAC. The results showed: TIRADS score had sensitivity 90%, specificity 77.8% and accuracy of 82.14%. The elastography score had sensitivity 80%, specificity 88.9% and accuracy 85.7%. The use of the strain ratio had 80% sensitivity, 94.4% specificity and 89.3% accuracy. DWI and ADC value had 100% sensitivity and 94.4% specificity and the accuracy was 96.4% for differentiating malignant from benign thyroid nodules. Multi-parametric analysis by TIRADS and ADC had 100% accuracy. Conclusion Ultrasound elastography add valuable data over ultrasound TIRADS. But, diffusion weighted MRI and ADC value has more accuracy in differentiating malignant from benign thyroid nodules. The best performance was achieved by the combination of ACR-TIRADS and ADC value.

scholarly journals Metrics for evaluating polygenic risk scores

2020 ◽  
Author(s):  
Stuart G Baker
Keyword(s):  
Clinical Utility ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Predictive Performance ◽  
Risk Scores ◽  
Correct Prediction ◽  
Polygenic Risk ◽  
Minimum Number ◽  
Probability Of Cancer ◽  
Prevalence Of Cancer

Abstract There is growing interest in the use of polygenic risk scores based on genetic variants to predict cancer incidence. The type of metric used to evaluate the predictive performance of polygenic risk scores plays a crucial role in their interpretation. I compare three metrics for this evaluation: the area under the Receiver Operating Characteristic curve (AUC), the probability of cancer in a high-risk subset divided by the prevalence of cancer in the population, which I call the subset relative risk (SRR), and the minimum test tradeoff (MTT), which is the minimum number of gene variant ascertainments (one per person) for each correct prediction of cancer to yield a positive expected clinical utility. I show that SRR is a relabeling of AUC. I recommend MTT for the evaluation of polygenic risk scores because, unlike AUC and SRR, it is directly related to the expected clinical utility.

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